Cat-Scratch Disease In Adult Hospitalized For Prolonged-Fever Associated With Multiple Lymphadenopathies and Weight Loss



Vincent Guiyedi*, 1, 2, 3, Hanna Haddad 4, Madeleine Okome-Nkoumou 2, 3, Fabien Gire 1, Brice Ongali 3, Philippes Lore 5, Luis Gameiro 1
1 Service de Médecine B-Hepato-Gastro-Enterologie, Centre Hospitalier de Tulle, France
2 Département de Maladies Infectieuses et Tropicales, Faculté de Médecine de Libreville, Université des Sciences de la Santé, Gabon
3 Service de Médecine Interne-Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire International Albert Schweitzer de Lambaréné, Université des Sciences de la Santé, Libreville, Gabon
4 Service de Chirurgie Orthopédique, Centre Hospitalier de Tulle, France
5 Service de Médecine Interne-Rhumatologie-Neurologie, Centre Hospitalier de Tulle, France


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© Guiyedi et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Service of Medecine B-Hepato-Gastro-Enterology, Tulle Hospital Center, France; Tel: 00 (33) 05 55 29 80 45; Fax: 00 (33) 05 55 29 80 90; E-mails: vincent.guiyedi@chui-asl.comguidyvin@hotmail.com


Abstract

We report a 19-year-old patient with a Cat-scratch disease presenting three months continuous alteration of the general condition, including prolonged-fever, anorexia, asthenia, weight loss associated with adenitis and multiple thoracic-abdominal adenopathies, leukocytosis with neutrophil polynuclear predominance, and increased of C-reactive protein. The serologies of toxoplasmosis, infectious mononucleosis, human immunodeficiency virus, Brucellosis, Bartonellosis and the tuberculosis research by tuberculin reaction test and Ziehl acid-alcohol resistant bacilli direct examination were negatives. The cytomegalovirus and Epstein-Barr virus serologies were positives only for immunoglobulin-G. The Bartonella henselae diagnosis was made with the analysis of histopathological specimens. The clinical and biological symptoms regressed following eight weeks of azithromycin's treatment.

According to this observation, the cat-scratch disease should be considered in differential diagnosis of patients presenting prolonged-fever associated with multiple lymphadenopathies and weight loss. The azithromycin would be an alternative therapeutic issue for this pathology in case of confirmed efficacy by studies in a large patient population.

Keywords: Azithromycin, cat-scratch disease, weight loss, adenopathies, prolonged-fever.